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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2024; 16(3): 732-749
Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.732
Combining systemic inflammatory response index and albumin fibrinogen ratio to predict early serious complications and prognosis after resectable gastric cancer
Jing-Yao Ren, Da Wang, Li-Hui Zhu, Shuo Liu, Miao Yu, Hui Cai
Jing-Yao Ren, Li-Hui Zhu, Hui Cai, School of Clinical Medicine, Ningxia Medical University, Yinchuan 750000, Ningxia Hui Autonomous Region, China
Jing-Yao Ren, Da Wang, Li-Hui Zhu, Shuo Liu, Miao Yu, Hui Cai, General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Jing-Yao Ren, Da Wang, Li-Hui Zhu, Shuo Liu, Miao Yu, Hui Cai, Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Jing-Yao Ren, Da Wang, Li-Hui Zhu, Shuo Liu, Miao Yu, Hui Cai, NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
Da Wang, Medical College of Jiangsu University, Jiangsu University, Zhenjiang 212013, Jiangsu Province, China
Shuo Liu, Hui Cai, The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
Co-first authors: Jing-Yao Ren and Da Wang.
Author contributions: Ren JY conceived and designed the study and wrote the manuscript; Ren JY, Wang D, Zhu LH, Liu S, and Yu M conducted all data collection and analysis and compiled charts; Cai H reviewed and revised the manuscript; All authors read and approved the final manuscript.
Supported by the National Natural Science Foundation of China, No. 8236110677; Central to guide local scientific and Technological Development, No. ZYYDDFFZZJ-1; Natural Science Foundation of Gansu Province, China, No. 18JR2RA033; and Gansu Da Vinci Robot High-End Diagnosis and Treatment Team Construction Project, National Key Research and Development Program, No. 2020RCXM076.
Institutional review board statement: The research protocol was approved by the Gansu Provincial Hospital Medical Ethics Committee in accordance with the principles of the Declaration of Helsinki.
Informed consent statement: Participants were exempted from informed consent.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hui Cai, Doctor, PhD, Chief Doctor, Dean, Doctor, General Surgery Clinical Medical Center, Gansu Provincial Hospital, No. 204 Donggang West Road, Cheng
guan District, Lanzhou 730000, Gansu Province, China.
caialonteam@163.com
Received: October 15, 2023
Peer-review started: October 15, 2023
First decision: November 22, 2023
Revised: December 9, 2023
Accepted: January 9, 2024
Article in press: January 9, 2024
Published online: March 15, 2024
Processing time: 148 Days and 22.4 Hours
BACKGROUND
Gastric cancer has a high incidence and fatality rate, and surgery is the preferred course of treatment. Nonetheless, patient survival rates are still low, and the incidence of major postoperative complications cannot be disregarded. The systemic inflammatory response, nutritional level, and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients. The systemic inflammatory response index (SIRI) and the albumin fibrinogen ratio (AFR) are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.
AIM
To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.
METHODS
We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019. We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications. We scored the patients and categorized them into three groups based on their SIRI and AFR levels. COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival (OS) and disease-free survival (DFS).
RESULTS
SIRI-AFR scores were an independent risk factor for prognosis [OS: P = 0.004; hazards ratio (HR) = 3.134; DFS: P < 0.001; HR = 3.543] and had the highest diagnostic power (area under the curve: 0.779; 95% confidence interval: 0.737-0.820) for early serious complications in patients with gastric cancer. The tumor-node-metastasis stage (P = 0.001), perioperative transfusion (P = 0.044), positive carcinoembryonic antigen (P = 0.014) findings, and major postoperative complications (P = 0.011) were factors associated with prognosis.
CONCLUSION
Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.
Core Tip: We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients. The aim of this study was to assess the clinical importance and prognostic significance of systemic inflammatory response index (SIRI) combined with the albumin fibrinogen ratio (AFR) on early postoperative outcomes in patients who underwent radical gastrectomy. The results demonstrated that preoperative SIRI and AFR were significantly associated with 5-year survival and the occurrence of major complications in gastric cancer patients. We created novel markers in the current study to aid in the early identification and therapy of gastric cancer.
